MSF Written Submission to the Canadian House of Commons Standing Committee on International Trade for consideration in the study of the Trans-Pacific Partnership Agreement
Doctors Without Borders/Médecins Sans Frontières (MSF) provides the following written submission regarding the impact that the Trans-Pacific Partnership (TPP) trade agreement will have on access to affordable medicines and biomedical innovation for consideration by the House of Commons Standing Committee on International Trade’s study of the Trans-Pacific Partnership Agreement.
As a medical humanitarian organization working in nearly 70 countries, MSF is in need of both affordable access to and innovation for medical technologies. Though our work, MSF witnesses the everyday impacts on people of having limited or no access to medicines. Drug prices need to be affordable so that our patients — and millions of others waiting for treatment — can get the medicines they need.
In our experience, generic competition saves lives by reducing price and increasing access. Competition among medicines producers has consistently proven to be a critical tool to lower drug prices and help deliver effective medical care. Patients, ministers of health and treatment providers like MSF rely on affordable, quality generic medicines to treat many life-threatening diseases, including tuberculosis, malaria, HIV/AIDS and other infections that afflict the poorest and most vulnerable people in the world.
However, new intellectual property obligations and other protections for pharmaceutical companies that limit price-lowering generic competition are driving up drug prices and limiting access to medical innovations. Several provisions included in the TPP will further reduce the timely availability of affordable medicines needed by MSF and patients around the world. The TPP puts in place new, far-reaching government obligations that lengthen, strengthen and broaden patents and other mechanisms that extend market exclusivities for pharmaceutical products. It will require some countries to change their national laws to implement these harmful new rules and will lock countries like Canada in to provisions that keep medicine prices unnecessarily high. The effect will be to further delay access to generic medicines beyond current requirements of international trade law, undermining the public health safeguards that governments and others have to promote access to medicines and limit abuse of pharmaceutical market exclusivity mechanisms. If enacted, the TPP will undermine existing Canadian global health commitments towards developing countries (such as Canada’s recent $785 million commitment to the Global Fund to Fight AIDS, Tuberculosis and Malaria), making medicines less affordable and less accessible to patients and treatment providers who need them.
The TPP will exacerbate the global crisis of high drug prices. For example, the TPP will prohibit national regulatory authorities from using existing clinical trials data demonstrating a pharmaceutical product’s safety and efficacy to authorize the sale of competitor products, even in the absence of patents by mandating data exclusivity periods. By 2014 the price to vaccinate a child had risen to 68 times more expensive than it was in 2001, with many countries unable to afford new high-priced vaccines that prevent countless deaths from diseases such as childhood pneumonia, which kills about one million children each year. The additional monopoly protections for biologic drugs and vaccines will keep already expensive products out of the hands of millions. The TPP will also force governments to extend existing patent monopolies beyond current 20-year terms at the request of 2 pharmaceutical companies, and to redefine what deserves a patent, including mandating the granting of new patents for modifications of existing medicines.
Instead of using trade deals to legislate protectionism for pharmaceutical companies through the TPP, Canada should seek to establish improved global norms to fix the world’s broken research and development (R&D) system. The sole reliance on high medicine prices, backed by exclusivities and monopolies, is a flawed paradigm for funding innovation. This leads to unaffordable prices while failing to stimulate innovation for diseases where patients have limited purchasing power, like neglected tropical diseases or where drugs have to be used sparsely like antibiotics. MSF supports the importance of rewarding innovators for undertaking the costs and risks of biomedical innovation. Alternative approaches could address some of the flaws in the current system of R&D by rewarding innovators for these efforts while prioritizing biomedical innovation in areas of public health importance. These approaches would not require people in need of lifesaving treatment to pay artificially high prices to fund this future work. Instead of doubling down on a broken model, the Canadian government should collaborate with other governments to introduce new approaches that promote both innovation and access.
The negative public health impacts of the TPP will be felt for years to come, and will not be limited to the more than 800 million people in the current 12 TPP countries. Other countries are already being invited to join or expressing interest to sign on. Additionally, by aiming to be a standard-setting agreement, it is a dangerous blueprint for future agreements and new global trade norms.
It is not too late to prevent the further restrictions on access to affordable medicines that would be created through the TPP. MSF urges the Canadian government to protect the right to health of millions of people that will be negatively impacted if the TPP is approved in its current form. The TPP should be rejected as long as damaging provisions for access to medicines remain in the final agreement.
This submission complements the intervention made by MSF at the 2016 Parliament Hearing and available here:
For more information on MSF’s concerns with the TPP, please read our 2016 issue brief on TPP and Health: